Some Moist Toilet Paper Can Cause Severe Reaction

TUESDAY, June 22 (HealthDay News) -- A preservative used in moist toilet paper can cause a severe allergic reaction in some people, as demonstrated by four case reports published online June 21 in the Archives of Dermatology.

Kevin H. Gardner, of the Mayo Clinic in Rochester, Minn., and colleagues describe four patients, including two women (ages 38 and 63) and two men (ages 49 and 70) who presented with severe perianal and perineal allergic contact dermatitis. The patients experienced pruritus, which had persisted from five months to as long as 20 years in the 70-year-old man, and their condition was resistant to treatment with ointments, topical and oral corticosteroids, Epsom salts, zinc oxide, and clobetasol propionate. Also, the 63-year-old woman had been misdiagnosed with pityriasis rubra pilaris and received methotrexate, which caused subsequent hepatotoxic effects.

On questioning the patients, the clinicians discovered that all had used moist toilet paper. Patch tests for methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), a preservative in some moist toilet paper brands linked to allergic contact dermatitis, were positive in all patients. When the patients stopped using the moist toilet paper, their dermatitis resolved.

"Along with others, we voice our concerns about MCI/MI being used as a preservative in cosmetics, industrial products, and moist toilet paper. Perianal and perineal dermatitis caused by moist toilet paper may be unrecognized and/or misdiagnosed, causing chronic discomfort and disability for many patients," the authors write.